Healthcare Provider Details

I. General information

NPI: 1164378824
Provider Name (Legal Business Name): DARIA JACOBSON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2494 BERNVILLE RD STE G02
READING PA
19605-9466
US

IV. Provider business mailing address

500 UNIVERSITY DR MC CA410
HERSHEY PA
17033
US

V. Phone/Fax

Practice location:
  • Phone: 610-378-2840
  • Fax:
Mailing address:
  • Phone: 800-243-1455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP033483
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP033483
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: